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Diagnostic effectiveness of biochemical liver-function tests, as evaluated by discriminant function analysis

P P Sher

    Clinical Chemistry
    |January 1, 1977
    PubMed
    Summary

    Liver function tests can help diagnose liver diseases, with aspartate aminotransferase and alkaline phosphatase being key indicators. Combining these tests improves diagnostic accuracy for conditions like tumors, cirrhosis, and hepatitis.

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    Area of Science:

    • Hepatology
    • Clinical Chemistry
    • Medical Diagnostics

    Background:

    • Liver function tests (LFTs) are commonly used in clinical practice.
    • Accurate diagnosis of hepatic diseases is crucial for effective treatment.
    • The diagnostic utility of standard LFTs requires further evaluation.

    Purpose of the Study:

    • To assess the diagnostic value of routinely ordered liver function tests.
    • To determine the classification accuracy of specific LFTs in biopsy-proven hepatic diseases.
    • To identify the most effective LFTs for differentiating liver conditions.

    Main Methods:

    • Stepwise discriminant analysis was applied to data from 175 patients.
    • Evaluated total and direct bilirubin, alkaline phosphatase, lactate dehydrogenase, and aspartate aminotransferase.

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  • Analyzed diagnostic accuracy based on the homogeneity of disease groups.

    • Main Results:

    • Overall classification accuracy ranged from 45% to 73%, varying with diagnostic group homogeneity.
    • Aspartate aminotransferase and alkaline phosphatase demonstrated the strongest discriminatory power.
    • Utilizing all tests in homogeneous groups (tumors, cirrhosis, hepatitis) improved accuracy from 51% to 73%.

    Conclusions:

    • Routinely ordered liver function tests possess diagnostic value for hepatic diseases.
    • Aspartate aminotransferase and alkaline phosphatase are significant discriminators.
    • Combining multiple LFTs enhances diagnostic accuracy, particularly in homogeneous disease categories.